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Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

Child

Child and Youth Mental HealthPSP ModuleCopingSkillsCognitiveStrategyParenting a child with ADHD can be stressful. When stressed, parents mayexhibit negative parenting behaviours such as: yelling, hitting,inappropriate punishment. Help parents understand that such responses,although common, do not help.Provide parents with practical suggestions such as time‐out strategies andpositive reinforcement techniques. Refer the parents to resources forparent effectiveness training or parent counselling if they are available inthe patient’s community.Remind parents that many youth with ADHD grow up to be excellent attheir work, in the arts, in sports and in their lives.Encourage parents to fit their child’s skills to activities. For example, manychildren with ADHD have difficulty in highly structured team sports (i.e.,baseball) but excel at more individual sports (i.e., swimming, tennis)Encourage parents to enrol their child in active, structured, pro‐socialcommunity organizations (e.g., boys / girls clubs).Cognitive strategies that are sometimes useful for teens are largelyineffective with young children.Help caregivers better understand their emotional reaction to their child’sbehaviour.Don’t react, Parenting a child with ADHD is challenging!What happened?It’s Thursday night, you’re tired after a day of work. You sit with yourchild to supervise their homework, and find out that they have a mathexam tomorrow and they didn’t bring home any notes or book to study.YOU GET ANGRY / FRUSTRATED!Things like this have happened so many times before…Don’t react, “Stop and think”.Children with ADHD receive a tremendous amount of negativefeedback. Criticism and nagging are not going to improve the actualsituation.Take time to breath and think!Resources - Psychotherapeutic Support for Children Caregivers (PSC)_2011_07_04 2 of 4

Child and Youth Mental HealthPSP ModuleHow you can do it better…There is not much that you can do tonight, but at least you can try notto make it worse. You can ask your child to recall what they have beenreviewing in class and make some practice exercises together.Next day, you can ask the teacher to give you the dates of any exams inadvance and help your child to write them down on their agenda, aswell as some reminders on days before the exam to help themremember to bring the books needed to prepare in advance.BehaviourStrategyChildren with ADHD do better in structured environments!Establish an organized household routine including meal times, schoolwork and bedtime. This routine should be predictable, but flexible to thechild’s needs and should not be rigid.Help parents to: create simple systems of organization; develop a tokeneconomy at home; the use of charts is useful for children under age of 12years.For more tips and information about parenting and behaviouralintervention for children with ADHD, refer to the references for familiesToken Economy is a behaviour modification technique that aims to increasedesirable behaviour and decrcease undesirable behaviour with the use oftokens or small positive rewards at the moment of success, “displayingdesirable behaviour”.The tokens (e.g., stickers, other small objects) are collected and later exchangedfor a meaningful object or privilege (e.g., choice of meal for dinner, selection ofa favorite book during bedtime story time). A token economy should not takethe place of, but rather supplement other parenting techniques such as advice,support, etc. Rewards for children need to be more immediate than withadults. Waiting for the weekend to be rewarded for what the child does onMonday is not useful.MedicationIntroProvide rationale for using medication to caregivers including thepotential benefits, as well as potential risks about the medication.Teach parents about how to give medication to children who may havetrouble swallowing larger pills that cannot be sprinkled into food. Alsodiscuss with caregivers the need to include the school in medicationinformation if they need to be involved in administering during the schoolday, as is often the case with short acting medicines (i.e., Ritalin).Talk to the child in developmentally appropriate language about theResources - Psychotherapeutic Support for Children Caregivers (PSC)_2011_07_04 3 of 4

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